Epidemiology

Etiology

• Strong association with Epstein-Barr virus (EBV)
• Immunodeficiency: e.g., organ or cell transplantation, immunosuppressants, HIV infection , chemotherapy
• Autoimmune diseases (e.g., rheumatoid arthritis, sarcoidosis)

Pathophysiology

Clinical features

• B symptoms
  • Night sweats, weight loss > 10% in the past 6 months, fever > 38°C (100.4°F)
• Pel-Ebstein fever: Intermittent fever with periods of high temperature for 1–2 weeks, followed by afebrile periods for 1–2 weeks. Relatively rare but very specific for HL.
• Alcohol-induced pain: Pain in involved lymph nodes after ingestion of alcohol. Relatively rare but highly specific for HL.

Diagnostics

Histology

• Lymph node excision
  • Reed-Sternberg cells (RSCs)
    • Tumor cells that are pathognomonic of HL
    • Originate from B cells
    • Large cells with binuclear/bilobed nuclei with dark centers of chromatin and pale halos, which results in an owl-eye appearance on histopathologic examination.
    • CD15/CD30-positive
  • Hodgkin cells: mononuclear, malignant B lymphocytes
    • Polynuclear RSCs are giant cells formed through the fusion of multiple Hodgkin cells.

Treatment